Drug interactions
Lorlatinib + Mestranol
Severity: Major
Lorlatinib and Mestranol: major interaction.
Last updated Sources: US FDA label
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Lorlatinib is a CYP3A4 inducer and may lower exposure to mestranol, an estrogen used in oral contraceptives, risking contraceptive failure and breakthrough bleeding.
What this interaction means in plain words
Lorlatinib and Mestranol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
CYP3A4 induction accelerates estrogen metabolism.
What to do
Advise an additional nonhormonal contraceptive method during lorlatinib and for a period after stopping.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Lorlatinib
- Amobarbital + Lorlatinib Contraindicated
- Apalutamide + Lorlatinib Contraindicated
- Butabarbital + Lorlatinib Contraindicated
- Carbamazepine + Lorlatinib Contraindicated
- Enzalutamide + Lorlatinib Contraindicated
- Fosphenytoin + Lorlatinib Contraindicated
Frequently asked questions
Can I take Lorlatinib with Mestranol?
MediHelp rates the interaction as major. Lorlatinib and Mestranol can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Lorlatinib is a CYP3A4 inducer and may lower exposure to mestranol, an estrogen used in oral contraceptives, risking contraceptive failure and breakthrough bleeding.
How serious is the interaction between Lorlatinib and Mestranol?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise an additional nonhormonal contraceptive method during lorlatinib and for a period after stopping.
What other medicines interact with Lorlatinib?
MediHelp also lists interactions of Lorlatinib with, for example, Amobarbital, Apalutamide, Butabarbital. The full list is on the Lorlatinib page.
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